Medication
There is not an absolute cure for atrial flutter. But that shouldn’t worry you a lot. Atrial flutter is a sort of supraventricular arrhythmias that appears with older people. It is not a life...
Procedures
You should be able to live an active, normal life. However, there's a significant risk that can get in the way of that. The biggest threat to a good prognosis with atrial fibrillation — or Afib — is having a stroke, and Afib increases your stroke risk considerably.
Self-care
The cardiologist said that sometimes atrial flutter corrects itself, however, and the conversion treatment is not necessary. I was wondering if anyone has had this experience (Atrial flutter correcting itself).
Nutrition
Treatment may fail to control your symptoms, and you may need to return for different treatment. Atrial flutter increases your risk for heart failure or other heart conditions. An irregular heartbeat could lead to a life-threatening blood clot or stroke.
Is there an absolute cure of atrial flutter?
Can You Live a normal life with atrial flutter?
Can atrial flutter cure itself?
Is it safe not to treat atrial flutter?
What is best treatment for atrial flutter?
Currently, atrial flutter is successfully "cured" by radiofrequency catheter ablation; but treatment to restore atrial fibrillation to sinus rhythm has been the traditional use of medications and external cardioversion.
Can atrial flutter be treated with medication?
Antiarrhythmic drug treatment can be used to convert atrial flutter to sinus rhythm. Three drugs—ibutilide, flecainide, and propafenone—have a reasonable expectation of accomplishing this. Ibutilide, which can only be used intravenously, is associated with a 60% likelihood of converting atrial flutter to sinus rhythm.
Which medication is being used to treat the atrial flutter?
Drugs used to treat Atrial FlutterDrug nameRatingRx/OTCGeneric name: esmolol systemic Drug class: cardioselective beta blockers, group II antiarrhythmics For consumers: dosage, interactions, side effects For professionals: Prescribing InformationView information about Sotylize SotylizeRateRx40 more rows
Can you live a normal life with atrial flutter?
Most patients with atrial flutter lead an entirely normal life with modern drugs and treatments.
What triggers atrial flutter?
It's caused by an abnormal electrical circuit in the upper chambers of the heart (atria) that makes the atria beat quickly and flutter instead of fully squeezing. It can result in fast heart rates and a heart that doesn't work as well as it should. This increases the risk for stroke and may cause you to feel poorly.
What is the first line treatment for atrial flutter?
Use of catheter ablation is not only beneficial for treating atrial flutter but also can significantly reduce hospital visits – both inpatient and emergency – and lower the risk for atrial fibrillation, according to research by UC San Francisco.
How successful is ablation for atrial flutter?
In general, more than 90% of patients with atrial flutter will be cured of their arrhythmia after an ablation procedure .
Is walking good for atrial flutter?
In fact, walking can prove quite beneficial to the health and longevity of a person living with AFib. Why? Aside from its long-term health benefits, such as lower blood pressure and resting heart rate and improved mental well-being, walking can help reduce the onset of AFib symptoms.
Does atrial flutter shorten life expectancy?
Untreated AFib can raise your risk for problems like a heart attack, stroke, and heart failure, which could shorten your life expectancy.
Is exercise good for atrial flutter?
“And for people with AFib, regular exercise can help keep the condition in check,” Dr. Khan says. Researchers have found that among people who have atrial fibrillation, those who are most fit have the fewest AFib episodes. People with the lowest levels of fitness, by contrast, have more frequent episodes.
How to cure atrial flutter?
Currently, atrial flutter is successfully "cured" by radiofrequency catheter ablation; but treatment to restore atrial fibrillation to sinus rhythm has been the traditional use of medications and external cardioversion.
Why is arrythmia surgery so effective?
Even in arrythmias that can be controlled with drugs, the procedure has been shown to be cost effective because it eliminates medication failures that require hospitalization. It also is an attractive option for elderly patients who are prone to suffer side effects from drug therapy and women of childbearing age who can't take medications because of potential health risk to the fetus.
How does a catheter ablation work?
Catheter ablation involves threading a tiny metal-tipped wire catheter through a vein or artery in the leg and into the heart. Fluoroscopy, which allows cardiologists to view on a monitor the catheter moving through the vessel, provides a road map. Other catheters, usually inserted through the neck, contain electrical sensors to help find the area causing the short-circuits. The metal-tipped catheter is then maneuvered to each problem site and radiofrequency waves — the same energy used for radio and television transmission — gently burn away each unwanted strand of tissue. When catheter ablation was first tried, direct current shocks were used, but researchers later developed the use of radiofrequency waves — a more precise form of energy. With radiofrequency catheter ablation, patients usually leave the hospital in one day, compared to open heart surgery, which requires a week stay and months of recovery.
How does a CRT work?
CRT devices work by pacing both the left and right ventricles simultaneously, which results in resynchronizing the muscle contractions and improving the efficiency of the weakened heart. In the normal heart, the electrical conduction system delivers electrical impulses to the left ventricle in a highly organized pattern of contractions that pump blood out of the ventricle very efficiently. In systolic heart failure caused by an enlarged heart (dilated cardiomyopathy), this electrical coordination is lost. Uncoordinated heart muscle function leads to inefficient ejection of blood from the ventricles.
How do pacemakers work?
They are small devices that are implanted beneath the skin below the collarbone and connected to a pace wire (s) positioned inside the heart via a vein; this delivers a small electrical impulse to stimulate the heart to beat when it is going too slow.
Where is the implantable cardioverter defibrillator located?
It is slightly larger than a pacemaker and usually is implanted beneath the skin below the collarbone. It is connected to a defibrillation/pace wire (s) positioned inside the heart via a vein.
Does radiofrequency ablation work?
For conditions like Wolff-Parkinson-White syndrome, in which a hair-thin strand of tissue creates an extra electrical pathway between the upper and lower chambers of the heart, radiofrequency ablation offers a cure. It has become the treatment of choice for patients with that disorder who don't respond well to drug therapy or who have a propensity for rapid heart rates.
How to treat a flutter?
The first step in treatment is to restore a normal rate and sinus rhythm. There are two ways to do this: medication and defibrillation. Electrical cardioversion: The doctor gives your heart a shock to regulate your heartbeat.
What to do if you have a flutter?
If you've been diagnosed and are being treated for atrial flutter, go immediately to a hospital emergency department if you: Have severe chest pain.
How does AFIB affect the heart?
About one-third of people who have AFib also have atrial flutter. In atrial flutter, electrical impulses don't travel in a straight line from the top of your heart to the bottom. Instead, they move in a circle inside the upper chambers. As a result, your heart beats too fast, but still in a steady rhythm.
How long does a paroxysmal atrial flutter last?
Paroxysmal atrial flutter can come and go. An episode of atrial flutter usually lasts hours or days.
What is the danger of atrial flutter?
The main danger with atrial flutter is that your heart doesn’t pump blood very well when it beats too fast.
What causes a flutter in the heart?
Heart diseases or problems that can cause atrial flutter include: Ischemia: Lower blood flow to the heart due to coronary heart disease, hardening of the arteries, or a blood clot. Hypertension: High blood pressure. Cardiomyopathy: Disease of the heart muscle. Abnormal heart valves: Especially the mitral valve.
What is it called when your heart beats so fast?
It usually slows the beats by a fourth or a half, or down to somewhere between 150 and 75 beats per minute. An abnormally fast heart rate is called ta chycardia. Because atrial flutter comes from the atria, it is called a supraventricular (above the ventricles) tachycardia.
How to control atrial flutter?
Whenever rapid control of the ventricular response rate to atrial flutter is desirable, use of either an intravenous calcium channel blocking agent (verapamil or diltiazem) or an intravenous β blocking agent (usually esmolol, although propranolol or metoprolol can also be used) is usually effective. Aggressive administration of a digitalis preparation, usually intravenously, to control ventricular rate (it might also convert the atrial flutter either to atrial fibrillation with a controlled ventricular response rate or to sinus rhythm) is also acceptable, but generally is not the treatment of choice except in the presence of pronounced ventricular dysfunction. DC cardioversion of atrial flutter to sinus rhythm has a very high likelihood of success. When this mode of treatment is selected, it may require as little as 25 joules, although at least 50 joules is generally recommended because it is more often successful. Because 100 joules is virtually always successful and virtually never harmful, it should be considered as the initial shock strength.
What antiarrhythmics can be used to treat atrial flutter?
Antiarrhythmic drug treatment can be used to convert atrial flutter to sinus rhythm. Three drugs—ibutilide, flecainide, and propafenone—have a reasonable expectation of accomplishing this. Ibutilide, which can only be used intravenously, is associated with a 60% likelihood of converting atrial flutter to sinus rhythm. 16 Because ibutilide dramatically prolongs ventricular repolarisation, and consequently the Q-T interval, there is a small incidence of torsades de pointes associated with its use. 17 However, these episodes, should they occur, are usually self limited, and because of the short half life of this drug, the period of such risk is quite brief, usually less than one hour. Nevertheless, one should be prepared to administer intravenous magnesium and even perform DC cardioversion to treat a prolonged episode of torsades de pointes should it occur when using ibutilide. Flecainide and propafenone, when used intravenously 18 or when used orally but in a single high dose (300 mg for flecainide or 600 mg for propafenone) also may be effective in cardioverting this rhythm to sinus. When using either of these drugs, the atrial rate may slow dramatically—for example, to 200 bpm. Therefore, it is best given with a calcium channel blocker or β blocker to prevent the possibility of 1:1 AV conduction of the significantly slowed atrial flutter rate. Antiarrhythmic drug treatment also may be used before performing either DC cardioversion or rapid atrial pacing: (1) to slow the ventricular response rate (with a β blocker, a calcium channel blocker, digoxin or some combination of these drugs); (2) to enhance the efficacy of rapid atrial pacing in restoring sinus rhythm (use of procainamide, disopyramide or ibutilide); or (3) to enhance the likelihood that sinus rhythm will be sustained following effective DC cardioversion (use of a class IA, class IC or class III antiarrhythmic agent).
How to restore sinus rhythm?
When atrial flutter is diagnosed , three options are available to restore sinus rhythm: (1) administer an antiarrhythmic drug; (2) initiate DC cardioversion; or (3) initiate rapid atrial pacing to terminate the atrial flutter (fig 4 ). Selection of acute treatment for atrial flutter with either DC cardioversion, atrial pacing or antiarrhythmic drug therapy will depend on the clinical presentation of the patient and both the clinical availability and ease of using these techniques. Since DC cardioversion requires administration of an anaesthetic agent, this may be undesirable in the patient who presents with atrial flutter having recently eaten or the patient who has severe chronic obstructive lung disease. Such patients are best treated with either antiarrhythmic drug therapy or rapid atrial pacing to terminate the atrial flutter, or with an AV nodal blocking drug to slow the ventricular response rate. When atrial flutter is associated with a situation requiring urgent restoration of sinus rhythm—for example, 1:1 AV conduction or hypotension—prompt DC cardioversion is the treatment of choice. For the patient who develops atrial flutter following open heart surgery, use of the temporary atrial epicardial wire electrodes to perform rapid atrial pacing to restore sinus rhythm is the treatment of choice (fig 4 ).
What is the most common tachyarrhythmia after atrial fibrillation?
After atrial fibrillation, atrial flutter is the most important and most common atrial tachyarrhythmia. Although it was first described 80 years ago, techniques for its diagnosis and management have changed little for decades. The diagnosis rested almost entirely with the 12 lead ECG, and treatment options included only the use of a digitalis compound to slow and control the ventricular response rate, and/or the use of either quinidine or procainamide in an attempt to convert the rhythm to sinus rhythm or to prevent recurrence of atrial flutter once sinus rhythm was established.
How does atrial flutter occur?
While those studies have been and continue to be most helpful, a series of studies in patients—principally using catheter electrode mapping and pacing techniques—has established that classical atrial flutter is caused by a re-entrant circuit confined to the right atrium in which the impulse travels up the atrial septum, with epicardial breakthrough superiorly in the right atrium where the impulse then travels inferiorly down the right atrial free wall to re-enter the atrial septum (fig 1 ). 2-7 When the circulating wave front re-enters the atrial septum, it travels through an isthmus bounded by the inferior vena cava, Eustachian ridge, the coronary sinus os on one side and the tricuspid valve annulus on the other side (the “atrial flutter isthmus”). Atrial flutter caused by this mechanism is called typical atrial flutter, 8 although it also has been called common atrial flutter and counterclockwise atrial flutter. A 12 lead ECG during typical atrial flutter with characteristic negative “sawtooth” atrial flutter waves in leads II, III, and aVF is shown in fig 2. It is also recognised that impulses can travel in this re-entrant circuit in the opposite direction, so that the impulse travels down the atrial septum and breaks through to the epicardium via the same atrial flutter isthmus to travel up the right atrial free wall and then re-enter the septum superiorly (fig 1 ). 3 This form of atrial flutter is called reverse typical atrial flutter, 8 although it has in the past been called atypical atrial flutter, clockwise atrial flutter, uncommon atrial flutter, and rare atrial flutter. A 12 lead ECG during reverse typical atrial flutter with characteristic positive flutter waves in leads II, III, and aVF is shown in fig 3.
What is the most common atrial tachyarrhythmia?
Treatment of atrial flutter. After atrial fibrillation, atrial flutter is the most important and most common atrial tachyarrhythmia. Although it was first described 80 years ago, techniques for its diagnosis and management have changed little for decades.
What causes atrial flutter?
9 Interestingly, it has recently been shown 10 that when atrial flutter does occur chronically in patients following repair of congenital heart defects, it is usually caused by a re-entrant circuit that includes the atrial flutter isthmus. Additionally, a left atrial flutter is now recognised that is thought generally to circulate around one or more of the pulmonary veins or the mitral valve annulus, but this re-entrant mechanism has not been well characterised. And finally, there are some forms of atrial flutter which are quite unique, and have now been called truly atypical atrial flutter. 8
Where is atrial flutter cured?
While the symptoms are similar, the treatments may differ. Typical atrial flutter is localized to the right atrium. This type of atrial flutter can be cured with a short outpatient catheter ablation procedure. Atypical atrial flutter refers to atrial flutter arising in the left atrium.
How to diagnose flutter in heart?
Atrial flutter is normally diagnosed in your physician's office using an electrocardiogram (ECG or EKG). If the diagnosis is still in question, your doctor may recommend a Holter monitor, an event monitor or an electrophysiological study, during which a narrow, flexible tube called a catheter is threaded through a vein to your heart under light sedation. Fine wires inside the catheter can help pinpoint the abnormal signal.
What is atypical atrial flutter?
Atypical atrial flutter refers to atrial flutter arising in the left atrium. Most types of atypical atrial flutter can also be treated with catheter ablation, but the procedure is longer and more involved.
Why is flutter important?
Atrial flutter is important not only because of its symptoms but because it can cause a stroke that may result in permanent disability or death.
Which is less effective, catheter ablation or antiarrhythmics?
Medications to control the heart rhythm, called antiarrhythmics, may be less effective than catheter ablation
Where does the heart beat?
A normal heartbeat begins with an electrical impulse from the sinus node, a small area in the heart's right atrium (right upper chamber). During atrial flutter, the short circuit — a circular electrical pathway — allows the electrical impulse to quickly move around the right atrium, causing between 240 and 340 contractions per minute.
Is a flutter atypical or atypical?
Atrial flutter is classified as typical or atypical (non-typical) depending on the location of the short circuit — the pathway that allows the electrical signal to move too fast around the heart. While the symptoms are similar, the treatments may differ.
What are the treatments for atrial flutter?
There are effective treatments for atrial flutter, including medication or procedures designed to scar small areas of heart tissue (ablation).
What is a flutter in the heart?
Atrial flutter is a type of heart rhythm disorder in which the heart's upper chambers (atria) beat too quickly.
Is atrial flutter a disorder?
Atrial flutter is similar to atrial fibrillation, a common disorder that causes the heart to beat in abnormal patterns. People with atrial flutter have a heart rhythm that's more organized and less chaotic than that of atrial fibrillation. Sometimes you may have episodes of both atrial flutter and atrial fibrillation.
How to treat atrial flutter?
Maintain a healthy weight. Control high blood pressure ( hypertension) and high cholesterol. If a person has already experienced an episode of atrial flutter, a health care provider should be seen regularly and his or her treatment recommendations should be strictly followed .
When to seek medical attention for atrial flutter?
When to Seek Medical Care for Atrial Flutter. If a person experiences any of the symptoms suggestive of atrial flutter, a health care provider should be called for an appointment. If symptoms are severe or alarming, urgent medical attention should be sought.
How long does atrial flutter last?
Atrial flutter can come and go; it is then known as paroxysmal atrial flutter. More often, atrial flutter lasts for days to weeks and is known as persistent atrial flutter. With proper treatment, atrial flutter is rarely life- threatening.
What is the name of the abnormality in the heartbeat?
Atrial flutter is an abnormality of the heart rhythm, resulting in a rapid and sometimes irregular heartbeat. Such abnormalities, whether in the rate or regularity of the heartbeat, are known as arrhythmias.
What is the danger of atrial flutter?
The main danger of atrial flutter is that the heart does not pump blood well when it is beating too fast. When blood is not pumped well, vital organs, such as the heart and brain, may not get enough oxygen from the blood. Atrial flutter can come and go; it is then known as paroxysmal atrial flutter.
What causes a heart to flutter?
Heart diseases or abnormalities that can cause atrial flutter include the following: Decreased blood flow to the heart (ischemia) due to coronary heart disease, hardening of the arteries ( atherosclerosis ), and/or a heart attack. High blood pressure ( hypertension)
Why is an ambulatory ECG important?
The purpose of an ambulatory ECG is to obtain documented proof of the arrhythmia. Proof is important because treatment depends upon identification of the arrhythmia.
Why do doctors use atrial flutter ablation?
Doctors use atrial flutter ablation to control the signs and symptoms associated with atrial flutter. Atrial flutter ablation may restore a normal heart rhythm, which may improve your quality of life.
What is the purpose of scarring in the atrial flutter?
Heat (radiofrequency energy) is applied to the target area, damaging the tissue and causing scarring. The scarring helps block the electrical signals that are causing your atrial flutter.
What is the procedure to create scar tissue in the upper chamber of the heart?
Atrial flutter ablation is a procedure to create scar tissue within an upper chamber of the heart in order to block the electrical signals that cause a fluttering heartbeat. Atrial flutter occurs when your heart's electrical signals tell the upper chambers of your heart (atria) to beat too quickly.
Where is flutter ablation done?
Atrial flutter ablation is done in the hospital. You'll receive a medication called a sedative that helps you relax. Once the sedative takes effect, a small area near a vein, usually in your groin, is numbed. The doctor inserts a long flexible tube (catheter) into the vein.
How does a doctor do ablation?
The doctor inserts a long flexible tube (catheter) into the vein. He or she carefully guides the catheter into your heart. Sensors on the tip of the catheter send electrical impulses and record your heart's electricity. Your doctor uses this information to determine the best place to apply the ablation treatment.
Can you have an atrial flutter after cardiac ablation?
Most people see improvements in their quality of life after this type of cardiac ablation, but there's a chance your atrial flutter may return. If this happens, the procedure may be repeated or you and your doctor might consider other treatments.
Mechanism
Classification
Signs and symptoms
Treatment
Specialist to consult
Diagnosis
Prognosis
- All these types of atrial flutter fall under the category of type I atrial flutter as described by Wells and colleagues.11They are distinguished by the fact that they can always be interrupted by rapid atrial pacing, and have a rate range between 240340 beats/min (bpm).11 Type II atrial flutter11is a more rapid atrial flutter (rates >340 bpm) which is still being characterised. It is presently though…
Medical uses
- Atrial flutter typically is paroxysmal, usually lasting seconds to hours, but on occasion lasting longer. Occasionally, it is a persistent rhythm. Atrial flutter as a stable, chronic rhythm is unusual, as it usually reverts either to sinus rhythm or to atrial fibrillation, either spontaneously or as a result of treatment. However, atrial flutter has been reported to be present for up to 20 years or …
Prevention
- When atrial flutter is diagnosed, three options are available to restore sinus rhythm: (1) administer an antiarrhythmic drug; (2) initiate DC cardioversion; or (3) initiate rapid atrial pacing to terminate the atrial flutter (fig 4). Selection of acute treatment for atrial flutter with either DC cardioversion, atrial pacing or antiarrhythmic drug t...
Funding
- Similarly, when incisional re-entrant atrial flutter is identified by electrophysiological mapping techniques, a vulnerable isthmus usually can be identified and successfully ablated using radiofrequency catheter ablation techniques.9 There is insufficient information available to discuss the likely efficacy of successful radiofrequency ablation techniques to cure left atrial flu…